Pub Date : 2021-08-03eCollection Date: 2021-06-01DOI: 10.2217/ijh-2020-0021
Julio C Chavez, Farah Yassine, Jose Sandoval-Sus, Mohamed A Kharfan-Dabaja
Aims: To review recent data and relevant of the role of anti-CD19 chimeric antigen receptor (CAR) T-cell therapy for B-cell non-Hodgkin lymphoma (NHL).
Methods: Review and compilation of the most recent and relevant data published in full text and abstract forms of anti-CD19 CAR T-cell therapy for B-cell NHL.
Results: Different anti-CD19 CAR T-cell therapy products have been tested and shown significant clinical activity across B-cell NHL patients. The objective responses in relapsed DLBCL, FL and MCL were 50-83%, 83-93% and 93%, respectively.
Conclusions: Anti-CD19 CAR T-cell therapy is a viable option for poor risk refractory B-cell NHLs.
目的:回顾抗cd19嵌合抗原受体(CAR) t细胞治疗b细胞非霍奇金淋巴瘤(NHL)的最新数据和相关作用。方法:回顾和汇编最近发表的有关抗cd19 CAR - t细胞治疗b细胞NHL的全文和摘要形式的相关数据。结果:不同的抗cd19 CAR - t细胞治疗产品已经过测试，并在b细胞NHL患者中显示出显着的临床活性。复发的DLBCL、FL和MCL的客观有效率分别为50-83%、83-93%和93%。结论:抗cd19 CAR - t细胞疗法是治疗低风险难治性b细胞nhl的可行选择。
{"title":"Anti-CD19 chimeric antigen receptor T-cell therapy in B-cell lymphomas: current status and future directions.","authors":"Julio C Chavez, Farah Yassine, Jose Sandoval-Sus, Mohamed A Kharfan-Dabaja","doi":"10.2217/ijh-2020-0021","DOIUrl":"https://doi.org/10.2217/ijh-2020-0021","url":null,"abstract":"<p><strong>Aims: </strong>To review recent data and relevant of the role of anti-CD19 chimeric antigen receptor (CAR) T-cell therapy for B-cell non-Hodgkin lymphoma (NHL).</p><p><strong>Methods: </strong>Review and compilation of the most recent and relevant data published in full text and abstract forms of anti-CD19 CAR T-cell therapy for B-cell NHL.</p><p><strong>Results: </strong>Different anti-CD19 CAR T-cell therapy products have been tested and shown significant clinical activity across B-cell NHL patients. The objective responses in relapsed DLBCL, FL and MCL were 50-83%, 83-93% and 93%, respectively.</p><p><strong>Conclusions: </strong>Anti-CD19 CAR T-cell therapy is a viable option for poor risk refractory B-cell NHLs.</p>","PeriodicalId":14166,"journal":{"name":"International Journal of Hematologic Oncology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/78/cf/ijh-10-33.PMC8445151.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39432917","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-06-22eCollection Date: 2021-06-01DOI: 10.2217/ijh-2021-0002
Ming Liu, Fang Wang, Yang Zhang, Xue Chen, Panxiang Cao, Daijing Nie, Jiancheng Fang, Mingyu Wang, Mingyue Liu, Hongxing Liu
Aim: This study aimed to investigate the regularity of gene mutations in patients with myelodysplastic syndrome (MDS) and in those that progressed to acute myeloid leukemia (MDS/AML). Patients & methods: High-throughput sequencing technology was used to detect gene mutations in 99 newly diagnosed patients with MDS or MDS/AML. Results: Gene mutations were detected in 88 patients. The mutation incidence in the MDS/AML group was significantly higher than that in the MDS group. Statistically significant differences were observed between the MDS with refractory anemia (MDS-RA) and MDS-RA with excess blasts groups and between the MDS/AML and MDS-RA groups. Conclusion: Our data demonstrate that there is a cumulative accumulation of gene mutations, especially in transcription factor genes, during disease progression in MDS and MDS/AML.
{"title":"Gene mutation spectrum of patients with myelodysplastic syndrome and progression to acute myeloid leukemia.","authors":"Ming Liu, Fang Wang, Yang Zhang, Xue Chen, Panxiang Cao, Daijing Nie, Jiancheng Fang, Mingyu Wang, Mingyue Liu, Hongxing Liu","doi":"10.2217/ijh-2021-0002","DOIUrl":"https://doi.org/10.2217/ijh-2021-0002","url":null,"abstract":"Aim: This study aimed to investigate the regularity of gene mutations in patients with myelodysplastic syndrome (MDS) and in those that progressed to acute myeloid leukemia (MDS/AML). Patients & methods: High-throughput sequencing technology was used to detect gene mutations in 99 newly diagnosed patients with MDS or MDS/AML. Results: Gene mutations were detected in 88 patients. The mutation incidence in the MDS/AML group was significantly higher than that in the MDS group. Statistically significant differences were observed between the MDS with refractory anemia (MDS-RA) and MDS-RA with excess blasts groups and between the MDS/AML and MDS-RA groups. Conclusion: Our data demonstrate that there is a cumulative accumulation of gene mutations, especially in transcription factor genes, during disease progression in MDS and MDS/AML.","PeriodicalId":14166,"journal":{"name":"International Journal of Hematologic Oncology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-06-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/5d/0c/ijh-10-34.PMC8446821.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39432919","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Venetoclax - a novel, orally bioavailable inhibitor of B-cell lymphoma-2 - has demonstrated substantial clinical activity in the treatment of chronic lymphocytic leukemia. Alone or in combination with other targeted agents, venetoclax results in high rate of durable responses and undetectable measurable residual disease. The peculiarity of venetoclax is that it allows for fixed durations of therapy of 12 months in the frontline and 24 months in the relapsed/refractory setting, with a favorable impact on compliance and pharmacoeconomics. This approach implies a change of therapeutic paradigm in chronic lymphocytic leukemia from continuous to time-fixed therapy. Nowadays, it remains challenging to identify patients suitable for the optimal approach. Clinical trials addressing the issue of continuous versus time-limited therapy are ongoing.
{"title":"Venetoclax: a real game changer in treatment of chronic lymphocytic leukemia.","authors":"Stefano Molica","doi":"10.2217/ijh-2020-0010","DOIUrl":"https://doi.org/10.2217/ijh-2020-0010","url":null,"abstract":"<p><p>Venetoclax - a novel, orally bioavailable inhibitor of B-cell lymphoma-2 - has demonstrated substantial clinical activity in the treatment of chronic lymphocytic leukemia. Alone or in combination with other targeted agents, venetoclax results in high rate of durable responses and undetectable measurable residual disease. The peculiarity of venetoclax is that it allows for fixed durations of therapy of 12 months in the frontline and 24 months in the relapsed/refractory setting, with a favorable impact on compliance and pharmacoeconomics. This approach implies a change of therapeutic paradigm in chronic lymphocytic leukemia from continuous to time-fixed therapy. Nowadays, it remains challenging to identify patients suitable for the optimal approach. Clinical trials addressing the issue of continuous versus time-limited therapy are ongoing.</p>","PeriodicalId":14166,"journal":{"name":"International Journal of Hematologic Oncology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2217/ijh-2020-0010","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38700734","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Multiple myeloma (MM) is one of the common hematological malignancies and, according to SEER data, 32,000 newly diagnosed cases are reported per year. It accounts for 1.8% of all cancers and around 17% of all hematological malignancies in the USA [1]. The presentation of MM is variable, with patients usually presenting with back pain, anemia and/or renal failure, while a small percentage of patients present with explosive clinical course, which can be life threatening. Despite several new drugs being approved by the US FDA (MD, USA) in the past few years, MM remains incurable and the overall survival (OS) of newly diagnosed high-risk MM patients is poor. Some of the challenges in achieving long-term remission or potential cure in MM patients are intraclonal and interclonal heterogeneity and lack of reliable indicators of deep treatment response. Minimal residual disease (MRD) assay is one such tool for measuring deeper response to treatment which, if sustained, could pave the way for cure. In an attempt to facilitate accurate comparison of novel treatment strategies, in 2006 the International Myeloma Working Group (IMWG) developed the first international consensus criteria for response evaluation in MM based on the guidelines published by the European Group for Blood and Bone Marrow Transplant/International Bone Marrow Transplant Registry (EBMT/IBMTR) in 1998 [2,3]. Complete response (CR) was defined as absence of monoclonal protein in the serum and/or urine and bone marrow showing less than 5% plasma cells. To refine the response assessment, the 2011 IMWG guidelines introduced four-color flow cytometry and allele specific oligonucleotide-PCR (ASO-PCR) to define immunophenotypic CR and molecular CR as new criteria [4]. This could be considered an early version of today’s MRD. Attainment of CR using the conventional serological and morphological assessment has been shown to result in prolonged survival [5]. However, MM is still incurable and several patients experience disease relapse eventually. This highlights the fact that the current tools of assessment of tumor burden cannot measure the disease in its entirety and it is this small population of myeloma cells termed residual disease that could lead to relapse. This has led to efforts to create tools, both imaging and molecular, which are more efficient to evaluate deeper responses that eventually culminated in the concept of MRD. IMWG, in their updated consensus response criteria in 2016, has further clarified several aspects of MRD assessment, methods of MRD detection and expanded the response criteria by incorporating imaging-based MRD negativity to rule out the presence of extramedullary disease [6]. Methods to measure MRD can be broadly classified as molecular methods that measure medullary disease (disease in the bone marrow) and imaging techniques that measure extra medullary disease (disease outside the marrow). Multiparameter flow cytometry (MFC), ASO-PCR and next-generation sequencing
{"title":"Minimal residual disease in multiple myeloma: are we there yet?","authors":"Srinivas Devarakonda, Yogesh Jethava","doi":"10.2217/ijh-2020-0018","DOIUrl":"https://doi.org/10.2217/ijh-2020-0018","url":null,"abstract":"Multiple myeloma (MM) is one of the common hematological malignancies and, according to SEER data, 32,000 newly diagnosed cases are reported per year. It accounts for 1.8% of all cancers and around 17% of all hematological malignancies in the USA [1]. The presentation of MM is variable, with patients usually presenting with back pain, anemia and/or renal failure, while a small percentage of patients present with explosive clinical course, which can be life threatening. Despite several new drugs being approved by the US FDA (MD, USA) in the past few years, MM remains incurable and the overall survival (OS) of newly diagnosed high-risk MM patients is poor. Some of the challenges in achieving long-term remission or potential cure in MM patients are intraclonal and interclonal heterogeneity and lack of reliable indicators of deep treatment response. Minimal residual disease (MRD) assay is one such tool for measuring deeper response to treatment which, if sustained, could pave the way for cure. In an attempt to facilitate accurate comparison of novel treatment strategies, in 2006 the International Myeloma Working Group (IMWG) developed the first international consensus criteria for response evaluation in MM based on the guidelines published by the European Group for Blood and Bone Marrow Transplant/International Bone Marrow Transplant Registry (EBMT/IBMTR) in 1998 [2,3]. Complete response (CR) was defined as absence of monoclonal protein in the serum and/or urine and bone marrow showing less than 5% plasma cells. To refine the response assessment, the 2011 IMWG guidelines introduced four-color flow cytometry and allele specific oligonucleotide-PCR (ASO-PCR) to define immunophenotypic CR and molecular CR as new criteria [4]. This could be considered an early version of today’s MRD. Attainment of CR using the conventional serological and morphological assessment has been shown to result in prolonged survival [5]. However, MM is still incurable and several patients experience disease relapse eventually. This highlights the fact that the current tools of assessment of tumor burden cannot measure the disease in its entirety and it is this small population of myeloma cells termed residual disease that could lead to relapse. This has led to efforts to create tools, both imaging and molecular, which are more efficient to evaluate deeper responses that eventually culminated in the concept of MRD. IMWG, in their updated consensus response criteria in 2016, has further clarified several aspects of MRD assessment, methods of MRD detection and expanded the response criteria by incorporating imaging-based MRD negativity to rule out the presence of extramedullary disease [6]. Methods to measure MRD can be broadly classified as molecular methods that measure medullary disease (disease in the bone marrow) and imaging techniques that measure extra medullary disease (disease outside the marrow). Multiparameter flow cytometry (MFC), ASO-PCR and next-generation sequencing","PeriodicalId":14166,"journal":{"name":"International Journal of Hematologic Oncology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2217/ijh-2020-0018","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38700733","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Yajaira Valentine Jimenez-Antolinez, Elias Eugenio Gonzalez-Lopez, Ileana Yazmín Velasco Ruiz, Marcela Cantu-Moreno, David Gomez-Almaguer, Oscar Gonzalez-Llano
A concordant leukemia is that which occurs in a pair of monozygotic twins; a similar genetic background suggests an in utero monoclonal origin. We present the case of a pair of monozygotic infants with concordant acute myeloid leukemia who underwent a peripheral blood hematopoietic stem-cell transplant (HSCT) from a single, younger human leukocyte antigen-identical sibling donor, using a fractioned graft collected during only one apheresis procedure. Twin A relapsed at +456 and received a second haploidentical HSCT from his father, twin B has been in complete remission since the first HSCT. Both children are in complete remission and with negative minimal residual disease at +900 (after second transplant) and +1488, respectively.
{"title":"Concordant acute myeloblastic leukemia in identical twins treated with allogeneic transplantation from a younger HLA-identical sibling following a single apheresis procedure.","authors":"Yajaira Valentine Jimenez-Antolinez, Elias Eugenio Gonzalez-Lopez, Ileana Yazmín Velasco Ruiz, Marcela Cantu-Moreno, David Gomez-Almaguer, Oscar Gonzalez-Llano","doi":"10.2217/ijh-2020-0017","DOIUrl":"https://doi.org/10.2217/ijh-2020-0017","url":null,"abstract":"<p><p>A concordant leukemia is that which occurs in a pair of monozygotic twins; a similar genetic background suggests an <i>in utero</i> monoclonal origin. We present the case of a pair of monozygotic infants with concordant acute myeloid leukemia who underwent a peripheral blood hematopoietic stem-cell transplant (HSCT) from a single, younger human leukocyte antigen-identical sibling donor, using a fractioned graft collected during only one apheresis procedure. Twin A relapsed at +456 and received a second haploidentical HSCT from his father, twin B has been in complete remission since the first HSCT. Both children are in complete remission and with negative minimal residual disease at +900 (after second transplant) and +1488, respectively.</p>","PeriodicalId":14166,"journal":{"name":"International Journal of Hematologic Oncology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-11-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2217/ijh-2020-0017","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39238200","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Istemi Serin, Aslıhan Bayir, Hasan Goze, Osman Yokus
Paroxysmal nocturnal hemoglobinuria (PNH) is defined by acquired intravascular hemolytic anemia, thrombosis and bone marrow failure with pancytopenia. Systemic lupus erythematosus (SLE) also appears as an autoimmune disease. The coexistence of both is rarely reported. Here we report the case of a 30-year-old female presenting with pancytopenia and diagnosed as SLE, who also had a PNH clone. Bone marrow biopsy did not support hypoplastic anemia. The patient was then followed up with the consideration of the existence of a PNH clone with SLE. She was treated by the rheumatology department and complete blood count improved under immunosuppressive treatment. The coexistence of CD59-CD55 deficiency with autoimmune diseases has been reported. It is an important example in terms of receiving clinical response with SLE-specific treatment.
{"title":"A case report: paroxysmal nocturnal hemoglobinuria and systemic lupus erythematosus association.","authors":"Istemi Serin, Aslıhan Bayir, Hasan Goze, Osman Yokus","doi":"10.2217/ijh-2020-0013","DOIUrl":"https://doi.org/10.2217/ijh-2020-0013","url":null,"abstract":"<p><p>Paroxysmal nocturnal hemoglobinuria (PNH) is defined by acquired intravascular hemolytic anemia, thrombosis and bone marrow failure with pancytopenia. Systemic lupus erythematosus (SLE) also appears as an autoimmune disease. The coexistence of both is rarely reported. Here we report the case of a 30-year-old female presenting with pancytopenia and diagnosed as SLE, who also had a PNH clone. Bone marrow biopsy did not support hypoplastic anemia. The patient was then followed up with the consideration of the existence of a PNH clone with SLE. She was treated by the rheumatology department and complete blood count improved under immunosuppressive treatment. The coexistence of CD59-CD55 deficiency with autoimmune diseases has been reported. It is an important example in terms of receiving clinical response with SLE-specific treatment.</p>","PeriodicalId":14166,"journal":{"name":"International Journal of Hematologic Oncology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/54/76/ijh-10-30.PMC8191648.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39240231","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Brynne Underwood, Qiuhong Zhao, Alison R Walker, Alice S Mims, Sumithira Vasu, Meixiao Long, Tamanna Z Haque, Bradley W Blaser, Nicole R Grieselhuber, Sarah A Wall, Gregory K Behbehani, James S Blachly, Karilyn Larkin, John C Byrd, Ramiro Garzon, Tzu-Fei Wang, Bhavana Bhatnagar
Aim: There are limited data describing incidence of symptomatic venous thromboembolism (VTE) in adolescent and young adult (AYA) acute lymphoblastic leukemia (ALL) patients receiving peg-asparaginase.
Materials & methods: Single-institution retrospective analysis of 44 AYA ALL patients treated with peg-asparaginase. Rates of VTE and proposed risk factors were assessed.
Results: 18 patients (41%) had a symptomatic VTE following peg-asparaginase. The cumulative incidence rate was 25% (95% CI: 13-38%) within 30 days of the initial dose. Personal history of thrombosis was statistically significantly associated with an increased risk of VTE with HR of 2.73 (95% CI: 1.40-5.33, p = 0.003) after adjusting for gender.
Conclusion: These data indicate a high rate of VTE in the AYA ALL population following treatment with peg-asparaginase.
{"title":"Incidence of venous thrombosis after peg-asparaginase in adolescent and young adults with acute lymphoblastic leukemia.","authors":"Brynne Underwood, Qiuhong Zhao, Alison R Walker, Alice S Mims, Sumithira Vasu, Meixiao Long, Tamanna Z Haque, Bradley W Blaser, Nicole R Grieselhuber, Sarah A Wall, Gregory K Behbehani, James S Blachly, Karilyn Larkin, John C Byrd, Ramiro Garzon, Tzu-Fei Wang, Bhavana Bhatnagar","doi":"10.2217/ijh-2020-0009","DOIUrl":"https://doi.org/10.2217/ijh-2020-0009","url":null,"abstract":"<p><strong>Aim: </strong>There are limited data describing incidence of symptomatic venous thromboembolism (VTE) in adolescent and young adult (AYA) acute lymphoblastic leukemia (ALL) patients receiving peg-asparaginase.</p><p><strong>Materials & methods: </strong>Single-institution retrospective analysis of 44 AYA ALL patients treated with peg-asparaginase. Rates of VTE and proposed risk factors were assessed.</p><p><strong>Results: </strong>18 patients (41%) had a symptomatic VTE following peg-asparaginase. The cumulative incidence rate was 25% (95% CI: 13-38%) within 30 days of the initial dose. Personal history of thrombosis was statistically significantly associated with an increased risk of VTE with HR of 2.73 (95% CI: 1.40-5.33, p = 0.003) after adjusting for gender.</p><p><strong>Conclusion: </strong>These data indicate a high rate of VTE in the AYA ALL population following treatment with peg-asparaginase.</p>","PeriodicalId":14166,"journal":{"name":"International Journal of Hematologic Oncology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7521187/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38452332","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Garrick Edouard Laudin, Peter F Levay, Buks Coetzer
Multiple myeloma, a hematological malignancy typified by the clonal expansion of bone marrow plasma cells, contributes to one percent of all malignancies worldwide. Despite myeloma only contributing to 10% of all hematological malignancies, it carries significant morbidity owing to its heterogenous presentation from orthopedic manifestations to renal sequelae. Patients with the disease can be risk stratified into high risk categories by the presence of various cytogenetic and other laboratory measures, albeit expensive. The albumin:globulin ratio and its inverse the globulin:albumin ratio is proposed as a means of predicting survival in this group of patients as a cheaper and more accessible marker of disease.
{"title":"Globulin fraction and albumin: globulin ratio as a predictor of mortality in a South African multiple myeloma cohort.","authors":"Garrick Edouard Laudin, Peter F Levay, Buks Coetzer","doi":"10.2217/ijh-2020-0003","DOIUrl":"10.2217/ijh-2020-0003","url":null,"abstract":"<p><p>Multiple myeloma, a hematological malignancy typified by the clonal expansion of bone marrow plasma cells, contributes to one percent of all malignancies worldwide. Despite myeloma only contributing to 10% of all hematological malignancies, it carries significant morbidity owing to its heterogenous presentation from orthopedic manifestations to renal sequelae. Patients with the disease can be risk stratified into high risk categories by the presence of various cytogenetic and other laboratory measures, albeit expensive. The albumin:globulin ratio and its inverse the globulin:albumin ratio is proposed as a means of predicting survival in this group of patients as a cheaper and more accessible marker of disease.</p>","PeriodicalId":14166,"journal":{"name":"International Journal of Hematologic Oncology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/0b/f7/ijh-09-27.PMC7521188.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38452331","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The Epstein-Barr virus (EBV) causes infectious mononucleosis (IM). In the case of atypical presentation, lymph node and tonsillar biopsies are required to rule out lymphoma. Here, we discuss an 83-year-old male who presented with findings suggestive of diffuse large B-cell lymphoma, which was later ruled out in favor of IM. The distinction between IM and lymphomas is quite challenging due to the extensive overlap between the two diseases. Various studies have demonstrated that EBV-positive diffuse large B-cell lymphoma mimics IM due to large B-cell proliferation in acute EBV infection. We suggest testing for acute EBV infection in addition to utilizing advanced testing to confirm IM in patients with atypical infection, to avoid misdiagnosis leading to inappropriate treatment.
{"title":"Infectious mononucleosis mimicking Epstein-Barr virus positive diffuse large B-cell lymphoma not otherwise specified.","authors":"Tejaswi Kanderi, Maged S Khoory","doi":"10.2217/ijh-2020-0002","DOIUrl":"https://doi.org/10.2217/ijh-2020-0002","url":null,"abstract":"<p><p>The Epstein-Barr virus (EBV) causes infectious mononucleosis (IM). In the case of atypical presentation, lymph node and tonsillar biopsies are required to rule out lymphoma. Here, we discuss an 83-year-old male who presented with findings suggestive of diffuse large B-cell lymphoma, which was later ruled out in favor of IM. The distinction between IM and lymphomas is quite challenging due to the extensive overlap between the two diseases. Various studies have demonstrated that EBV-positive diffuse large B-cell lymphoma mimics IM due to large B-cell proliferation in acute EBV infection. We suggest testing for acute EBV infection in addition to utilizing advanced testing to confirm IM in patients with atypical infection, to avoid misdiagnosis leading to inappropriate treatment.</p>","PeriodicalId":14166,"journal":{"name":"International Journal of Hematologic Oncology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2217/ijh-2020-0002","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38444133","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Jorge E Cortes, Carlo Gambacorti-Passerini, Michael Deininger, Elisabetta Abruzzese, Liza DeAnnuntis, Tim H Brümmendorf
Aim: Preclinical studies have shown reproductive toxicity with bosutinib, but little is known about its effects during conception or pregnancy in humans.
Methods: Pregnancy cases in patients receiving bosutinib were identified from the Pfizer safety database.
Results: Thirty-three pregnancy reports were identified. Sixteen cases of maternal exposure: six live births, four abortions and six with unknown outcomes. Seventeen instances of paternal exposure: nine live births, five abortions and three with unknown outcomes.
Conclusion: Adverse effects of bosutinib exposure at conception or during pregnancy in humans cannot be excluded, particularly if therapy is not interrupted upon recognition of pregnancy. Contraceptive use is recommended for female patients receiving bosutinib, and patients should be made aware of the potential risks associated with bosutinib use during pregnancy.
{"title":"Pregnancy outcomes in patients treated with bosutinib.","authors":"Jorge E Cortes, Carlo Gambacorti-Passerini, Michael Deininger, Elisabetta Abruzzese, Liza DeAnnuntis, Tim H Brümmendorf","doi":"10.2217/ijh-2020-0004","DOIUrl":"https://doi.org/10.2217/ijh-2020-0004","url":null,"abstract":"<p><strong>Aim: </strong>Preclinical studies have shown reproductive toxicity with bosutinib, but little is known about its effects during conception or pregnancy in humans.</p><p><strong>Methods: </strong>Pregnancy cases in patients receiving bosutinib were identified from the Pfizer safety database.</p><p><strong>Results: </strong>Thirty-three pregnancy reports were identified. Sixteen cases of maternal exposure: six live births, four abortions and six with unknown outcomes. Seventeen instances of paternal exposure: nine live births, five abortions and three with unknown outcomes.</p><p><strong>Conclusion: </strong>Adverse effects of bosutinib exposure at conception or during pregnancy in humans cannot be excluded, particularly if therapy is not interrupted upon recognition of pregnancy. Contraceptive use is recommended for female patients receiving bosutinib, and patients should be made aware of the potential risks associated with bosutinib use during pregnancy.</p>","PeriodicalId":14166,"journal":{"name":"International Journal of Hematologic Oncology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2217/ijh-2020-0004","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38541141","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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